Sheppard Pratt

My take on it: Describe the average day: Wake up at like 6 or so for weights and vitals, showers, then chill out until breakfast at 8. then menu planning, groups, supplements at around 10 or so if needed, groups, lunch at 12, groups, supplements at 3 if needed, group or free time until dinner at 5, free time, snack at 8:30, then at 9 go back get ready for bed.

What were meals like? Depended on if you were on rehab or stabilization, but overall it was a balanced meal containing a protein, starch, vegetable, etc…

What sorts of food were available or served? It actually wasn’t too bad, most of the things weren’t gross or greasy. Had a lot of vegetables and fresh fruit, sandwiches, hot meals, etc

Did they supplement? How did that system work? yes for weight gain or if you didn’t eat your meals

What level of activity or exercise was allowed? Very little except for movement group

What did people do on weekends? there was a lot of visiting hours but if you didn’t have a visitor they had a group or two and people would often get together and play things such as pictionary or something

Do you get to know your weight? kind of…the scales did not give you your weight in pounds..but you did get to see it unless you wanted a blind weight

How fast is the weight gain process? .2 kg per day

What was the average length of stay? depended on person..some like a week….some for months if that’s what they need

What was the average age range? all ages pretty much…just not really young kids I guess

When were you there? July 23 – August 11, 2008 Describe the average day: Wake up between 5:30 and 6 for vitals, weight, and shower. Go out to the main area at 7 and either sleep on a couch or watch the Today Show until breakfast at 8:15. Then meal planning, various groups, lunch at 12:15, more groups, dinner at 5:15, free time until snack at 8:30, another half-hour of free time, then back for “vanity” and bed at 9:30. Adults can go back out to the dayroom at 10, until 11, but adolescents have to go right to bed at 10.

What were meals like? Not bad! The first three days, you get standard trays; after that, you choose your own. During your first 3 days, you’ll meet with a dietitian who will explain the menus & meal plan to you. The meal plans are based on the food pyramid, which I liked because it’s simple – no need to figure out exchanges, just servings. The meals for the first 3 days SUCK, but somehow after that, it tastes better.

Did they supplement? How did that system work? Supplements were given for not gaining weight (up to 4 per day), and as meal replacements if you didn’t finish (1 or 2, depending on how much you ate).

What privileges are allowed? “fresh air break” – aka a chance to go outside – if there is adequate staff and you aren’t on restriction. Um… idk what else. Privileges are based on weight gain. If you don’t make weight, you can’t shower, make phone calls, or go outside on that day, and if you don’t finish a meal, you can’t make calls or go outside until the next day.

Does it work on a level system? Not really.

What sort of groups do they have? CBT, Self-Esteem, Motivation to Change, Art Therapy, Movement Therapy, Occupational Therapy, Interpersonal Relationships, Family Dynamics. Also specialty groups such as Healthy Sports Managements, Substance Abuse, and Male ED’s, that meet once or twice a week.

What was your favorite group? OT Task Group! We made jewelry, picture frames, stress balls, and other stuff. Well, there were those options… I just made jewelry at every group.

What did you like the most? The staff. They are wonderful. I don’t know how long ago the people with negative experiences were there, but I just got back 2 days ago, and the current staff is amazing. They are so kind, and patient, and really seem to care about everyone. Everyone is assigned to a staff member every day – your “contact person,” who will check in with you at some point (well, they’re supposed to, but it doesn’t always happen; however, there is a list posted by the nurses’ station, so you can always find out who your contact is if you need them) to see how you’re doing, if you need to talk, etc. Your contact person is also who you go to if you have any questions or concerns, or just want to talk. I will agree with others that sometimes they are very focused on “the program,” which can be frustrating. I had issues because of this, but I was able to talk to my individual therapist about it, and she helped me work out my situation and find ways to help.

What did you like the least? That privileges are tied to weight gain. I didn’t need to gain, but I felt bad for those who did, and who ate 100% and followed all the rules, and were still restricted because of things beyond their control. I also think they tend to overmedicate. I was upset and crying one day, and a nurse asked me if I wanted a PRN. I said no, I don’t even have anything prescribed, and she offered to talk to my doctor and get something. I had to argue with her, and later with someone else, about why I didn’t want more meds. It struck me as very odd – I was trying to learn to experience emotions and deal with them, not drug them away. However, you have the right to refuse any medication. Also, I told my Doctor that I didn’t want my current med combination messed with, and other than one small change, she respected that.

Would you recommend this program? YES. However, I would more highly recommend it for someone who can do PHP as well as IP. The program is designed with the assumption that you’ll do both, and most people are only IP for 10-14 days. So the IP groups are super repetitive. The IP groups are veeerrrryyy basic CBT, mostly for education and motivation… you do a lot of identifying negative patterns, etc. Then in PHP groups you move on to actually changing things, and it’s more in-depth. I could only do IP because of my insurance, and sitting in the groups for 3 weeks, literally going over the same stuff EVERY time, got really old. Sometimes people who can’t do PHP are allowed to go to the PHP groups for their last week or so, but I couldn’t because my Doctor said I wasn’t ready. That was frustrating, because I felt like I wasn’t really being prepared to go home.

What level of activity or exercise was allowed? NONE. EVER. If you are standing up for too long, you’ll be told to sit down.

What did people do on weekends? There would be 2 groups, and the rest of the time everyone watches movies, plays games, sleeps, etc.

Do you get to know your weight? Yes, unless your Doctor doesn’t want you to.

How fast is the weight gain process? 0.2 kg/day.

What was the average length of stay? 10-14 days IP, then 2-3 weeks PHP.

What was the average age range? Probably late teens/early 20’s. The youngest when I was there was 12, and the oldest was in her 60’s, I think.

When were you there: October-December 2008

Describe the average day: wake up at 5:30/weights/vitals…showers if permitted, out in the milieu by 7, breakfast at 8, groups/school until lunch at 12, groups/free time until dinner at 5. free time until snack at 8. bedtime at 10 for minors and 11 for adults.

What were meals like? huge. no really. the meal plans are very un-individualized. there are only 2. basic and standard. basic is as follows: breakfast=dairy + 4 items lunch=sandwich + 3 items + caloric beverage dinner=protein+ 2 starchy side items + veggie + fruit or dessert + caloric bev. snack=1 item + caloric beverage standard: breakfast=dairy + 5 items lunch=sandwich + 4 items(one of the items is required to be a dessert) + caloric bev. dinner=protein + 2 starchy sides + veggie + dessert + extra item + caloric bev. snack=1 item + caloric bev. if you’re on basic and still gaining when you aren’t supposed to, they won’t change your meal plan. I’ve seen girls gain as much as 20 pounds over their ideal weight and they never adjusted it. the first day you don’t gain 1/2 pound, you’re bumped up to standard…and after that they just add ensures in between the meals.

What sorts of food were available or served? the food was really disgusting. typical hospital food. everything that was supposed to be hot was cold, juice was frozen, milk was expired half the time…it was bad.

Did they supplement? How did that system work? supplement was the same for meals regardless of what meal plan you were on…which really didn’t make sense. if you didn’t eat at all, you got 2 supplements, if you ate all of your sides but not your entree you still got 2 supplements, and if you ate the entree but not the sides, or just couldn’t finish all the sides in time, you got 1 supplement. they also used ensure plus on top on the regular meal plan for weight gain, if there was ever a day that you didn’t gain a 1/2 pound, they’d add another ensure plus, even if you’d gained like 2 pounds the day before.

What privileges are allowed? all privileges are tied to weight gain. if you don’t “make weight”, you can’t shower, talk on the phone, do laundry, have visitors, shave etc. if you DO gain 1/2 pound…you can. it has nothing to do with how well you are complying with the program though. if you are eating 100% of your meals and you happen to not gain 1/2 pound on any given day-you automatically lose all privileges. but if you gain the 1/2 pound even if you aren’t complying with the program, you still have privileges. it was really frustrating.

Does it work on a level system? no.

What sort of groups do they have? a LOT of CBT and DBT.

What was your favorite group? I didn’t find any of them helpful.

What did you like the most? nothing.

What did you like the least? there are so many things I hated about Sheppard Pratt. first off, they told me point-blank that I would never recover. they told me that I could go into “remission” but that I would have an eating disorder for the rest of my life, and I had to accept that this was a chronic illness. secondly, the meal plan is ridiculous. it’s not based on food groups, calories, or exchanges, but “items”…which is such a loose program it’s basically as if you aren’t on a meal plan at all, and it feels very uncontrolled. like, with their system, an apple or a huge slice of banana cream pie are the same thing=1 item. depending on the person’s eating disorder, this system could really be abused. there was one girl there while I was inpatient who was a compulsive overeater, and she would order 4 donuts and a chocolate milk for breakfast every morning-and they were okay with that! it was really kind of crazy. third, the showering rule. it’s inhumane. and it’s NOT about exercising like everyone will try and tell you. …because if you try to wash your hair in the sink all hell with let loose. it’s a punishment. there’s really no way around that. fourth, the staff is incredibly rude. they make it very clear that they’re there for the money and then to get out. I was even told by a nurse when sitting with a supplement after a meal, “I don’t give a sh*t whether you eat or not, I just want my d*mn shift to be over so I can go home.” I’ve been in programs where the staff really does care, and it makes a HUGE difference.

Would you recommend this program? never.

What level of activity or exercise was allowed? they weren’t that strict on it. people could walk around, stand…there were even girls who would do laps up and down the hallways and never get caught. basically, you could do whatever you wanted…it was all about whether or not you wanted to shower the next day.

What did people do on weekends? nothing. the weekends were really boring.

2011

t’s been about a year since I’ve been in SP, however I have been there a few times in the past two-three years. My most recent trip there was difficult. I was hospitalized because I was in the midst of a severe manic episode, I just happened to have a history of an ED. The CED focused primarily on my eating disorder and not my manic episode, which was what really should have been addressed. Once they did manage to get my mania under control, I was able to eat, sit still and attend groups (which I was initially banned from because my hyperactivity was so disruptive). So if you have a comorbid disorder, think about what issues are most disruptive to your life. The CED did help with my eating disorder but it was difficult to get the comprehensive treatment I needed. I would suggest advocating for your needs. After all, you are your own best expert. With the exception of a few staff members, most were extremely caring and helpful. As an employee of SP I know that the staff at CED far exceed what the employee expectations are on other units and I am grateful for them going beyond what is expected of them. Other units do not hesitate to medicate patients and the CED is one of the only units in the entire SP health system that will talk you through your problems. The staff are truly there to help you. As a mental health worker I can tell you that absolutely no one is in it for the money, they do it because they care.

his goes on and on the whole day long. If staff sees a patient moving something, this gets fast attention. Moving a chair from one room to another gets a reprimand:
please don’t move the furniture, ask a staff member for help
you’re not supposed to move furniture
I don’t want you moving furniture, you’re supposed to ask someone for help

Shorthand and abbreviations at SP
ALP – activity limitation protocol. If a patient is suspected of exercising, excessive walking or is not gaining weight, a doctor may assign extra observation. On ALP, a patient is observed more carefully and told to sit more frequently. Officially, they are supposed to be seated at least 50 minutes per hour.
Zoning – if a patient is not gaining weight, their doctor might assign them to a specific seat in the milieu. This means that they must return to the same seat each time, instead of choosing any available chair.
On camera – a patient is monitored on a camera in their room which a nurse watches. If a patient is suspected of exercising, their doctor might put them ‘on camera’ so that nurses can catch them in the act.
Open door – if a patient is suspected of purging in the bathroom, a nurse will follow them and keep the bathroom door open while they use the bathroom. This is an extra level of observation, since every toilet requires a key to flush.
One-on-one – if a patient is found to be a risk to themselves or suspected of exercising during the day, a nurse will be assigned to follow them around all day wherever they go. If a patient is put on one-on-one, they usually have ‘open door’ bathroom breaks.

Your typical day at SP as an inpatient:
530-7 wake up around 530 for vitals and weigh-in, take a shower if you’ve gained at least 0.2kg
7-8 hang around in milieu
8-915 have blood drawn for lab tests if scheduled
915 bathroom break
930 water break and supplements
10 therapeutic group
11 therapeutic group
12 lunch
1 therapeutic group
215 bathroom break
230 water break and supplements
3 therapeutic group
4 therapeutic group
5 dinner
6-830 hang around in milieu
830 snack, supplements and water
930 evening bathroom
10 bedtime for minors
11 bedtime for adults

blood tests – Inpatients have daily tests for the first week, and weekly tests on Mondays afterward. PHP patients have daily tests for the first three days, and then weekly tests on Mondays. Doctors can also request other tests if they suspect eating disorder behavior since exercise and purging affect blood electrolyte concentrations.

water and nutritional supplements – during these breaks, all patients can drink an 8 oz cup of water along with any prescribed supplements. If patients do not gain weight by eating foods from the meal plan, their doctor will prescribe a supplement (ensure plus) each day. Each day a patient does not gain weight, their doctor can add a half supplement to their daily nutrition plan. Patients usually end up drinking 2-3 supplements daily, divided among the two breaks during the day and evening snack.

bedtime – minors (under 18) need to be in their bedrooms at 10pm. Adults can return to the milieu to read or watch TV until 11pm.

therapeutic groups – these can be any of CBT (cognitive behavioral therapy), DBT (dialectical behavioral therapy), IPT (interpersonal therapy), relapse prevention, mindfulness or nutritional education. Sometimes patients are taken for class to have individual therapy, family therapy or for a short daily meeting with their doctor.

medicines – SP provides all the medications patients are prescribed. There is a medication nurse who dispenses medications throughout the day. After talking with many patients, I found that seroquel was one of the most commonly prescribed drugs. It seems to relieve some of the patients’ anxiety, but they complain of drowsiness and fatigue through the day. It was frustrating to engage some patients in conversation, since they had trouble maintaining focus and would drift off.

Sheppard Pratt is a hospital just north of Baltimore MD for treating eating disorders. I went through a course of treatment starting as an inpatient and later PHP (partial hospitalization program). During my stay, I experienced what it’s like to be a patient. Looking back, I would give a mixed review of their program. If your are considering an eating disorder program, learn as much as you can before signing up.

Each meal was well prepared, including the buffet-style ‘therapeutic lunch’ each Wednesday. While some of the items were better than others, I have no complaints about the general quality of the food. Nurses were also flexible with patients in replacing any item that appeared undercooked or spoiled.

While the meals were usually tasteful and reasonably portioned, they had to be selected at least one day in advance. Once a patient submitted a menu with their selected items, they were only allowed to eat those items. Although patients were stuck with what they selected, it did prevent surprises during meals.

Mealtime rules seemed complicated and rigid to me. One of the major prohibition was making mixtures or combinations of foods. For example, dipping bread into a sauce or dipping a grilled cheese sandwich in tomato soup were not allowed. Combining two types of cereal in a single bowl was also forbidden. There were more prohibited combinations, such as:
adding salad greens to a sandwich
using salad dressing in place of mayonnaise on a sandwich
adding ketchup to any sandwich
dipping french fries in mustard
dipping cookies in milk during a snack
adding chocolate milk to cereal
While these rules were intended to ‘normalize’ eating behaviors, they felt restrictive and arbitrary.

On my first day at SP, the biggest change was the amount of water I could drink. Ever since I can remember, I always drank large amounts of water both during and between meals. At SP, patients are limited to water only at three break times throughout the day. We are allowed up to two 8 oz drinks with each of our meals, but additional water requires a doctor’s order.

Besides having limited water to drink, the air on the unit was usually very dry. My lips and skin dried out quickly, and I wanted to use chapstick and hand lotion. However, both of these need to be dispensed by the medication nurse, only at specific times. Like extra water, they required a doctor’s order. Even later in PHP, patients needed to first turn these in to the medication nurse who would later allow patients to use it when requested.

SP gives incentives to patients who gain weight, by allowing them privileges like phone and computer access. Each morning, patients wear a hospital gown and are weighed. Values are given in kg, to discourage anxiety about weight gain. Patients were expected to gain 0.2kg or more each day, and were put on ‘restriction’ otherwise. This meant that phone and computer privileges were revoked until the next day they gained 0.2kg.

Something that really irritated me were the times when staff enforced a rule, and then tried to comfort the patient. For example, they might tell a patient to stop talking on the phone if they were on restriction (from not gaining at least 0.2kg). The patient might have been in the middle of a conversation with one of their family members, a friend or their boss. Even so, they would disconnnect the phone with a switch in the back office and the patient would become visibly upset. Then the staff member would see them in a bad mood later, and ask if they ‘wanted to talk about it.’

Another bad mark on their report card would be the way they described their program at the outset. They say that the average stay for a patient is about two weeks as an inpatient, and then two or three weeks in PHP. However, you might end up staying longer if they judge your progress as insufficient. It can be tricky to leave SP when you want to, since they have ways of keeping you longer than you expected or would want to. All of the patients at SP are there voluntarily, since they sign a notice of signing up for voluntary treatment. In order to leave the treatment without a doctor’s consent, a patient can sign a 72 hour notice. However, your doctor might choose to commit you if they judge you a risk to yourself. The main reasons that they threaten involuntary commitment are:
being a risk to yourself (i.e. suicidal thoughts or self harm)
being under 75% of your ideal body weight (one of the criteria for anorexia nervosa is an inability or refusal to maintain 85% of ideal body weight)
not progressing in treatment (i.e. saying that you don’t want to recover)

Ending up in involuntary treatment is not fun. You get sent to a different part of the hospital for general psychiatric disorders, instead of the voluntary unit for eating disorders. This happens rarely, since most patients eventually withdraw their notice before 72 hours after talking with their parents or doctor.

SP prohibits physical exercise to help patients gain weight for therapy. However, it seems like they try to stop any mental activity also. Between classes, patients are expected to spend time in the ‘milieu,’ or community room. There are chairs and a few low tables, plus a television. Since many patients are in the milieu at the same time, it can get noisy. Patients and nurses are constantly talking, and at least one patient is being ‘redirected’ for doing something. Whenever someone vomits or breaks a rule in a major way, the group is called to a ‘community meeting.’ it’s hard to focus on anything when you’re in a noisy room full of constant motion.

Imagine trying to focus in an airport concourse or inside a moving bus. There are people all around you talking, television blaring, and information being announced. There is no surface to write on, and everything you have needs to be screened by security. They’ve taken away you scissors, glue, spiral bound notebook, three ring binder, headphones, computer and your cell phone too. I could tolerate these conditions for a few minutes while waiting for my flight. I would wait for my plane to arrive and get ready for departure. I would arrive at my destination and do something new.

This doesn’t happen at SP. If you change your seat, someone will tell you to sit down. If you try to stretch too much, someone will tell you to stop. This happens all day, with nurses watching what you are doing.

‘Caloric conservation’ is one of the major headaches I went through at SP. The protocol or rules are to prevent patients from moving in any unnecessary way, and to have them remain as sedentary as possible. Walking for any unnecessary distance will get you ‘redirected’ by nurses. Even standing for what they judge to be an excessive time will get you requests to sit down. Their voices still echo in my head:
could you please have a seat?
I need you to sit down now
please sit down, you’ve been standing for a while
you need to sit down now
I’d like you to find a seat now
I need everybody to sit down
if you aren’t waiting in line for the bathroom, you need to have a seat

Before you check in to Sheppard-Pratt, consider whether it matches your needs.

Sheppard-Pratt has two main programs: inpatient and outpatient. Inpatient focuses on gaining weight and introduces patients to cognitive therapy techniques. PHP, or partial hospitalization program, continues after patients have reached at least 75-85% of their goal weight. Cognitive behavioral therapy, dialectical behavioral therapy and family dynamics are the main therapies in both programs.

SP takes safety very seriously. patients cannot leave the locked unit without approval, and visitors are monitored. nurses watch the patients 24 hours a day, and log their location every 15 minutes. since some patients self-harm, the rules are obsessive towards safety. any items that might be used to harm (this includes staples and paperclips) are prohibited.

Since some patients have a habit of hiding foods or purging, any items that could hide foods are also banned. plastic bags and even envelopes were banned during my stay. There must have been some clever patients before my stay, since adhesive tape is also banned. Their explanation was that some patients like to hide things by taping them to the undersides of furniture.

The unit was also very clean, even with 30 people sharing the common spaces like dining room and living room AKA “milieu.” the dining rooms were used for classes too, but a visitor would have never known that a meal for thirty people had been served only hours before.
during my stay, most of the patients

the obsessive rules are my biggest complaint. it felt like living in a hostile environment since several nurses would supervise me during the entire day. Their main job is to remind us to sit down, since all inpatients are on ‘caloric conservation.’ This means that any activities that might burn any calories are prohibited. We were reminded to sit if standing for more than a minute or so. Some nurses even tried to remind patients to stop stretching.

Since more than half of the patients are minors, the nurses also monitor patients to ‘change the topic’ if conversation shifts to anything about food or a non-PC topic. The rules had to cater to minors too. This meant that movies rated above PG were prohibited, all CD’s needed to be screened before they could be played during meals or leisure, and magazines advertising articles unsuitable for minors were prohibited.

While therapy groups were divided by age, all other activities were communal. everyone would gather in the same living room for the times between classes, and meals were not divided by age. I understand that the rules were in place to protect safety and keep bad influences away from minors, but it felt like I was back in elementary school for my entire stay.

it took me a while to get used to the meal routines at SP. Among some of the many rules for this central event, we were expected to:
eat items separately and not combine foods
spread butter evenly across the entire surface of bread
add enough milk to cereal to keep it covered
wear only a single layer of clothing

Many of the patients had problems with the rules. One meal was an open face sandwich. While rules for this entree were not published or discussed before the meal, they were enforced. I watched staff members hover around several patients during a meal.

When one patient was seen eating the meat separately from the bread, the nurses took away her first sandwich and replaced it with another. They did the same after seeing another patient tearing portions with a fork instead of separating the portions with a knife. During the same meal, they replaced a third sandwich for another patient, saying that it must be cut with fork and knife, then eaten so that each forkful contains at least a portion of both meat and bread. Apparently, all of these rules are intended to ‘normalize’ eating behavior.

chronic disorganization was a big problem. at least one staff had to be in any room for every 5 patients. the staff were usually spending their time ‘supervising.’ the problem here is that if a patient had a request, the staff who were watching them could use the excuse that they were busy supervising patients and would not respond to the request.

it was hard to get a good night’s sleep here. every 15 minutes around the clock, a staff member has to record the location of a patient for security. while the staff can do this unobtrusively during the day and during classes, it made it hard to stay asleep. every 15 minutes, a staff member would open the door of my room and peer inside to make sure that i was still there and breathing. Plus, we had to wake up around 530.

Besides having a hard time sleeping at night, we were not allowed to take naps during the day. the staff justified the no-naps rule by saying that there were not enough couch spaces for people to recline without taking a seat from someone else. since everyone needs to remain seated instead of standing for long periods, they could say that napping would prevent someone else from sitting. even at times when there were spaces enough for people to recline and sit, the staff would tell us that we should spend the time between classes socializing, since this was another part of the therapy.

drinking enough water was another challenge. we were limited to 16 ounces of liquid during any meal, and had to get a doctor’s order to get an additional 8 ounces of water with a meal. aside from beverages at mealtimes, we were offered water during 3 breaks throughout the day. eight cups of water are recommended as a healthy intake. this means water, not water included in other beverages or food. doing the math, a patient with a doctor’s order for additional water who also took advantage of each water break would only get 6 cups: 3 during breakfast, lunch and dinner, plus the 3 breaks.

I wouldn’t recommend an eating disorder to anyone. this seems like a lifelong condition that I will need to deal with. I’ve only been to one inpatient treatment center in my lifetime, and can only offer my limited perspective. If you’re looking for a treatment center and considering SP, see if it matches your needs before signing up.

I was in SP inpatient in June 2011. It is hard core disciplined, there are no exceptions for acting on symptoms, and excuses are heard but not tolerated. It is the most restrictive eating disorder recovery environment I’ve been in. If you are interested in saving your life and can tolerate that this inpatient program is in the business of life saving and is less hard core therapy but rather hard core behavior modification, you will get a lot out of the program. I moved to a different program for PHP/IOP management as I don’t live in Maryland, but the experience. The program is “cookie cutter” but I do think that is based on the likelyhood that if you are sick enough to be inpatient that you need to have some serious intervention. I hated every second but I liked the outcome. It’s like taking a nasty tasting medicine that works; it’s worth it if you REALLY want recovery. Don’t waste your time if you aren’t ready.

2010

I have been here for a while now.

I fully believe the program is productive and good as long as YOU are willing to do the work. If you want a treatment that is comfortable/plush and where you can get away with behaviors without consequences – you will despise SP. If you want a program where behaviors are not tolerated, this is a good place. Yes, some aspects really honestly suck. Privilegeds are based upon weight gain, and while acting on your ED gain cause you to not make weight, sometimes you honestly do everything you are suppose to and do not make weight. However, this makes weight gain more of a positive thing. Additionally, many of the treatment team are very skilled. Some of the nurses suck ass, do not know anything about ED’s, and deserve to be fired… but some are simply amazing and I would love for them to adopt me. I am making progress in this treatment. They do not have gorgeous rooms or equine therapy, but they do provide you with abundant opportunities to not utilize your ED, learn new coping skills, and process what is going on. I would return here.

2010

When were you there?
i’ve been there several times but my last admission was this march-august (2010)

Describe the average day?
weights/vitals at 5:30, breakfast at 8, groups from 10-12, lunch at 12, groups from 1:30-5, dinner at 5:30, visiting hours from 7-8:30, snack at 8:30, lights out at 11.

What were meals like?
they have two dining rooms (one for PHP and one for inpatients) you sit at the tables and get called up by staff to prepare your tray. after you prepare your tray, you have 45 minutes to complete it. (they’ll usually give you extra time if you need it though) staff walk around the table and monitor and at the end of the meal, they check your tray to make sure you’ve completed everything.

it’s pretty basic stuff. cereals, yogurts, juices, fruits, toast, scrambled eggs, bagels, muffins etc. at breakfast…you have a lot of options. they tell you how many items you need and you can pick whichever ones you want. lunch is usually sandwiches and you get to choose the amount of sides you need for your meal plan from a selection of things like chips, pretzels, soups, fresh fruit or canned fruit, desserts, side salads etc. there are always three options for both lunch and dinner entrees, and you get to choose all of your sides.

Did they supplement? How did that system work?
if you eat less than 50% of your meal you get 2 supplements, more than 50% you get 1.
if you aren’t making weight, they’ll add permanent supplements to your meal plan (9:45 am, 2:45pm, and 9:00pm) you can get up to 4 permanent supplements.

What privileges are allowed?
if you are eating/making weight you can use the phones, have visitors, and use the computer at night.

What did people do on weekends?
you have groups in the morning and then the whole afternoon/evening is visiting hours. so if you don’t/can’t have visitors it gets pretty boring.

Do you get to know your weight?
yes. every morning.

How fast is the weight gain process?
they aim for .2 kilos a day (roughly 1/2 pound) so about 3-4 pounds a week.

What was the average length of stay?
it varies a lot. i definitely stayed a lot longer than most but i think in general it’s about 3 weeks inpatient and 3-4 in partial.

What was the average age range?
that varies a lot too. when i was there the youngest was 13 and the oldest was 57. they do divide up the groups though (18 and under, 18-24, and 24 and older)

What kind of aftercare do they provide?
they have a php program (7am to 7pm) and IOP (3pm-7pm), and they have outpatient providers as well.

Do they help you set up an OP treatment team?
yes.

How many IP beds?
26

Has anyone been to Sheppard Pratt’s free weekly support group? I’m looking into going, but I’m slightly hesitant because I don’t know what to expect or whether it’s worth it. Is it any good? What does the typical meeting look like?
I used to attend the group every week, but haven’t been in a year or so. I think it was worth it. There are “rules” that are explained at the beginning of what you can or can’t say (i.e triggering stuff). The group starts with an ice-breaker question that everyone answers, which is helpful. Some weeks there are about 10 people, and other weeks, there are like 30+. There is a group leader who is on staff at the CED, which is also good because they can add another view to things and they can also redirect inappropriate talk. You don’t have to raise your hand to speak, and after the initial “shyness” of the group, people are pretty comfortable talking. The group leader also prevents one person from taking the floor for too long….gives everyone a chance to speak if they chose to. The group takes place in a big room and you sit in chairs in a HUGE circle, so it’s not like you’re sitting right across from someone

16 comments

Carly

i know alot of people think sheppard pratt is bad but i do have a few questions. Do they deal well with self harm in the ED unit? Do they use feeding tubes? Do they ever restrain/physical holds on patients? or do they transfer you to psych for that

anonymous

Does it treat both males and females? Yes. They have separate bedrooms but joint therapy. There aren’t many males though.
How often do you see a medical doctor, psychiatrist, psychologist (therapist), nutritionist, etc? MD: first day, psychiatrist: every day for 10 minutes or so, psychologist: once or twice a week for 45-60 minutes, nutritionist: on your first or second day, in groups twice a week, when making menus (if you are an adult because parents make adolescent menus) and if you pull them over
What is the staff ratio to patients? Not sure, but lots of staff
What sort of therapies are used? (DBT, CBT, EMDR) etc? DBT, CBT, OT/task
Describe the average day: Wake up at 5:30, get vitals, shower, use the vanity, hang around until breakfast at 8, eat breakfast, go to groups, supplement, water, and bathroom breaks, go to lunch at 12:15, eat lunch, go to groups, supplement, water, and bathroom breaks, go to dinner at 5:30, eat dinner, have visitors until 8:30, eat snack and supplements, go to vanity at 9:30, go to bed at 10 (though adults can stay up until 11)
What were meals like? In inpatient, they were very structured (in PHP you had more freedom). You had to read the “dining room etiquette”, wear one layer of clothing, not bring any personal items, eat in a “not-disordered” manner… You would read the etiquette, then go set up your tray, then get 45 minutes to eat and make conversation/ play 20 questions, contact, etc. with your “peers”. A nurse would sit at each table and then check trays, shoes, and pockets. Then you’d put your tray up and play a game at the table for 15 minutes. People who didn’t finish were taken down for supplements.
What sorts of food were available or served? Pretty typical foods. There were two meal plans: basic and standard, and if you were over 5’9 you could be put on tall. Breakfast: Dairy+ Four items if on basic, + Five if on standard. Items were cereal, toast, eggs (from a carton), milk, yogurt, fruit, pancakes, french toast, bagels, donuts, breakfast meats, oatmeal, cream of wheat, grits… Lunch: sandwich meal plan: Caloric beverage+ sandwich+2 sides if on basic, 3 if on standard + dessert (at least 1 sweet a day if on basic, 2 if on standard). Some items were lemonade, pepsi, gingerale, milk, iced tea, juice, pb&j, tuna/chicken salad sandwich, grilled cheese, wraps, pretzels, chips, salad w/ dressing, other veggies, soup w/ crackers, fruit, applesauce, ice cream, sherbet, cake, cookie… Other meal plan: Caloric beverage+ 2 starches +1 protein +1 vegetable +dessert +extra item (if on standard). Items were potatoes, rice, dinner roll, toast, pasta, soup w/ crackers, chicken, beef, fish, corn, peas, cooked carrots, salad w/dressing, mixed vegetables, ice cream, sherbet, cake, cookie, and the extra item could be fruit or an extra serving of any other item. Wednesdays for the adults and Thursdays for the kids were therapeutic lunch days, where you ate with the nutritionist and ate food that people voted on and portioned out with the nutritionists’ help.
Did they supplement? How did that system work? Yes, if (and when) people did not gain the required amount of weight, they would get put, progressively, on a one time supplement and then on the standard meal plan, then on one supplement at night, then one in the morning, then one in the afternoon. Also, if you didn’t complete a meal you would get 1 or 2 supplements. An uneaten entree was 2, and if you ate half of the sides or so and the entree, it was 1. But there was no hard and fast rule, other than the entree one, about whether it was 1 or 2 supplements.
What is the policy of not complying with meals? You would get 15 minutes to complete replacement supplements or you would get a replacement tray ordered for the next meal (those were much bigger). If you didn’t complete them you would sit in the dining room until the next meal. Privileges sometimes got taken away on an individual bases, and you could not leave if you were not completing meals.
Are you able to be a vegetarian? No, because it was considered disordered behavior to eliminate a food group.
What privileges are allowed? Making phone calls at certain times, having visitors at certain times, speaking to nursing staff or the treatment team when you wanted… Not really that many privileges.
Does it work on a level system? I guess so, because they eventually break you (so it’s better to just start out with a good attitude).
What sort of groups do they have? CBT, DBT, mood management, social skills, snack group (ages 16 and up), OT/task, art, stress management, goals, structured leisure, nutrition, mindfulness, yoga (if you were at your goal weight and did not have a history of exercise problems).
What was your favorite group? OT/task because you could make crafts, and mindfulness because you could sleep. I think I would have liked yoga, but never got to do it.
What did you like the most? Some of the nurses and some of the patients were very funny and nice and it made it feel like teamwork rather than a struggle all alone.
What did you like the least? Inconsistent rule enforcement in terms of the dress code, triggering language (you’d get redirected), hugging/ high fiving other patients (we were in theory not allowed to touch) food rituals, emergency bathroom breaks, etc.
Would you recommend this program? I think staying home is always easier in the long run, but if that doesn’t work out, Sheppard Pratt has the structure that you might need to get back on track, so I would reccommend it.
What level of activity or exercise was allowed? None. You mostly had to sit, but in PHP they were not as strict about that. The only thing ever was yoga.
What did people do on weekends? Have visitors if inpatient, or sleep/watch TV if they had no visitors or were in PHP and didn’t have days off.
Do you get to know your weight? Unless you or your doctor thought your weight was too upsetting and you were “back to scale,” you got to know it every morning, in kilograms.
How fast is the weight gain process? .2 kilograms a day (.44 pounds).
What was the average length of stay? I stayed 2 weeks inpatient and 3 weeks PHP, which is what they say is average. But most people were inpatient for like 3 or 4 weeks and PHP for 3 or 4, if they cooperated. If they didn’t cooperate, some people went back and forth from the two programs for like 6 months. After a certain point though, if they think they’re not helping, they might send you elsewhere.
What was the average age range? In the adolescent unit it was ages 9-16. For the adults, most of them were in their 20s-40s.
How do visits/phone calls work? Phone calls are whenever there are no scheduled groups/meals. Visits are from 6:30-8:30 PM on weekdays, and from 3-5 PM and then 6:30-8:30 PM on weekends.
Are you able to go out on passes? If there are enough staff, everyone has completed meals and not self-harmed, and it is over 64 degrees, they might (but rarely) take you out to the walled courtyard.
What kind of aftercare do they provide? Do they help you set up an OP treatment team? They recommend IOP, but if you don’t do it (like me), then they find reliable people for an OP team. They were very good about that.

Maria Gorgone

I was in patient at Shepard Pratt February and March of 2010. It was the most humiliating and traumatizing experience of my life. The cruel and inhumane methods they used for you to gain weight was emotionally devastating. We were treated like prisoners who had no rights. The only way to survive the program was to comply. If you did not comply you were basically punished. There was only one focus gain weight at all cost. You had to finish every morsel of food on your plate. The staff hovered over you to ensure this. If you did not you were humiliated and told to finish. Every morning you got weighed. Not matter how heard you complied to the program if you did not gain weight you were punished….. No shower, no phone calls at all, couldn’t sit in the computer room, no visitors even if it was already scheduled. Would someone please tell me how this was motivating in any way. It was abusive. There was also a limit on water. My medication makes.very thirsty. I woke up one night and went to the bathroom. My. Mouth was parched . I went to splash a little water in my mouth and I was told to stop. I tried to explain but to no avail. I could not get back to sleep I was so thirsty. I could go on and on how horrible this experience was. My stay there still haunts me to this day. If you are suffering with an eating disorder my heart goes out to you. I would encourage anyone to seek help. You will gain weight at Shepard Pratt but at the loss of your dignity as a human being. I would highly discourage anyone to enter this program. There must be something better out there. Shepard Pratt is most definitely not that place!!!!!

kol

Wow. I was there in 2007 and it seems to have not changed a bit. Even Hopkins was better despite it being a brutal program as well at least it was a bit more individualized and humane. Though Sheppard Pratt meal plan and nutritionist were a bit better than Hopkins.

Maria Gorgone

My stay at Shepard Pratt was traumatizing. They used cruel and inhumane methods to get you to gain weight. The program should lose its accreditation. No one should have to experience humiliation and loss of their dignity to get well. There are other programs out there. I highly encourage you to seek them out.